OVERVIEW OF PATHOLOGY

Learning Outcomes

Students will be able to

1. Define Pathology and describe the history of
Pathology
2. Explain morbid pathology, microscopic & cellular
pathology, and molecular pathology
3. Understand the scope of Pathology
4. Explain the terminology used in Pathology
5. List the divisions of Pathology.

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 PATHOLOGY
DEFINITION
Pathology is the scientific study of the disease.
It constitutes a large body of scientific knowledge and investigative methods
essential for understanding disease and for effective medical practice.
Pathology composed of the functional and structural changes in disease, from
molecular level to effect on the individual.

Aim and objective***

The aim of pathology is the identification of the causes of disease.

The objective is to successful therapy and disease prevention.

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HISTORY OF PATHOLOGY

Plato (424-348 BC) and

Pythagoras c. 580-c 500 BC),
believed that disease was
due to the adverse effect of immaterial or
supernatural forces. Or often for punishment of
wrongdoing.

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HISTORY OF PATHOLOGY

Empedocles (490-430 BC) and Hippocrates (c. 460-370 BC)

Abnormal physical and postmortem finding are noticed.
The underlying disease was thought to be due to imbalance of various humors like phlegm, black
bile.

Galen (129-c.200)
He proposed disease are due to basis of anatomy and physiology.

Ibn Sina (980-1037) known as Avicenna by his Canon of Medicine

He proofed that the scientific discovery of Medicine.

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 The table shows that scientists and their discoveries
Plato (424-348 BC) and believed that disease was
Pythagoras c. 580-c 500 BC), due to the adverse effect of immaterial or supernatural forces.
Or often for punishment of wrong doing.

Empedocles (490-430 BC) and Hippocrates (c. 460-370) Abnormal physical and post mortem finding are noticed.
The underlying disease was thought to be due to imbalance
of various humors like phlegm, black bile.

Galen (129-c.200) He proposed disease are due to basis of anatomy and

physiology.

Ibn Sina (980-1037) He proofed that the scientific discovery of Medicine.

1800 Microscope
Louis Pasteur’s (1822-1895) Demonstration of microorganisms
Rudolf Virchow (1821-1902) Modern pathologist

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Pathology divided into TWO stages

A. GENERAL PATHOLOGY
B. SYSTEMIC PATHOLOGY

GENERAL PATHOLOGY
The mechanism and characteristic of
principle types of disease process.
Example – inflammation, tumors, and
degeneration

SYSTEMIC PATHOLOGY
The description of specific diseases as they
affect individual organs or organ system
Example- appendicitis , lung cancers ,
atheroma
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 Disease ******
Normal homeostasis
Response to environment ( genetic, infective agents, chemicals, radiation,
mechanical trauma)
Adaptation
Failure to adaptation - disease

Characteristic of disease-Signs-indication of a medical condition that can be objectively

observed (i.e., by someone other than the patient).
Symptoms-any manifestation of a condition that is apparent to the patient (i.e., something
consciously affecting the patient).
Knowledge and understanding of pathology
1. Epidemiology: incidence, prevalence and population distribution of a disease
2. Etiology: the causes of disease
3. Pathogenesis: mechanism causing diseases
4. Pathological and clinical features: structural and functional features of diseases
5. Complication and squeal: the secondary, systemic or remote consequence of a disease
6. Prognosis: the anticipated course of the disease in terms of cure, remission, or fate of
the patients
7. Treatment
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 EPIDEMIOLOGY

The incidence, prevalence and population distribution of the

disease.
Endemic goiter
occurs in geographic areas where the
diet contains little iodine. The designation
endemic is used when goiters are present in
more than 10% of the population in each region.
Particularly common in mountainous areas of
the world, including the Himalayas and the
Andes.

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 PATHOGENESIS OF MICROBRIAL DISEASE PROCESS IN
HUMAN BODY
Bacteria, viruses ,
protozoa

Etiology –the causes of disease

The science and study of AGENTS

the causes or origins of disease.

MODE
MODE OF Respiratory.GIT,
Sputum, OF ENTERY CVS,Renal ect.
urine,vomitus EXIST
stool

INVOLVE
PATHOG
D
Acute & ENESIS
ORGAN
chronic
inflammation
process
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 General classification of disease****
Congenital and acquired

Congenital subdivided into

1. Genetic ( inherited or sporadic mutation)e.g- Down’ syndrome
2. Non-genetic -autism and dementia, as well as mental illnesses such as
schizophrenia and depression.

Acquired

1. Inflammatory –acute appendicitis

2. Hemodynamic- thromboembolism
3. Growth disorders- Cretinism
4. Injury and disordered repair- keloid scar
5. Disordered immunity-autoimmune thyroiditis
6. Metabolic and degenerative disorders-diabetes ketosis
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 PATHOGENESIS
of a disease is the biological
mechanism that leads to the diseased
state.The origin and development of the
disease, and whether it is acute, chronic,
or recurrent.

Example of pathogenesis process-

1. Inflammation-chronic hepatitis
2. Degeneration-osteoarthrititis
3. Immune reaction- Grave disease
4. Carcinogenesis- colon cancer

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 NOMENCLATURES OF DISEASE

Primary and secondary

The primary and secondary are initial and
complication

Acute and chronic

Acute is rapid onset .
Chronic condition may follow an acute
episode ,but often are insidious onset and prolong
course.

Benign and malignant

Benign tumor remain localized in tissues of origin
and very rarely fatal.
Malignant is invasive and spread to other organs.
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 For understanding pathology
using prefixes and suffixes
• Commonly used prefixes and their
• Commonly used suffixes and their usual
usual meanings are: meanings are:
• ana- absence ( e.g. anaphylaxis) • -itis-an inflammatory process ( e.g. appendicitis)
• -oma, a tumour ( e.g. carcinoma)
• dys-disordered ( e.g. dysplasia) • -osis, state or condition , not necessarily
pathological)( e.g. osteoarthosis)
• hyper- an excess over normal ( e.g.
• -oid, resemblance to disease ( e.g. rheumatoid
hyperthyroidism) disease)
• hypo- a deficiency below normal ( e.g. • -penia, lack of ( e.g. thrombocytopenia)
hypothyroism) • -cytosis, increase in number of cells usually in
blood ( e.g. leukocytosis)
• meta- a change from one stage to • -ectasis, dilation ( e.g. bronchiectasis)
another ( e.g. metaplasia) • -plasia, disorder of growth ( e.g. hyperplasia)
• neo-, new ( e.g. Neoplasia) • -opathy, an abnormal state lacking specific
characteristics ( e. g. lymphadenopathy)

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Complication and squeal (secondary effects)

The secondary, systemic or remote consequences of diseases.

Prognosis (outcome)

The anticipated course of the disease in the term of cure,

remission ,or fate of the patients.

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 Comparing both normal pancreas and cystic adenoma pancreas
MORBID ANATOMY (GROSS
MORPHOLOGY)

Proper identification and orientation

of the specimen are imperative for the
adequate pathologic evaluation of a
case.

During the 18th and 19th centuries

Baillie Rokitansky and Aschoff
performed many thousand of
autopsies.

They correlated their gross findings

with clinical signs and symptoms. 17
 MICROSCOPIC AND CELLULAR PATHOLOGY

The light microscope can view the changes in disease tissue at a cellular level
Rudolf Virchow (1821-1902)
German pathologist advocate the microscope and see the cells that were
changed by disease process.
Advance biochemistry can help to investigate many disease at a molecular
level.

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 HISTOLOGY
The scientific study of the fine detail of
biological cells and tissues using microscopes to
look at specimens of tissues that have been HISTOLOGY OF THE SKIN
carefully prepared using special processes
called "histological techniques".

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 THE PROCESS OF HISTOPATHOLOGY
The tissue section are cut from tissue hardened by permeation with and embedding in
wax or less often transparent plastic.

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 Histopathology
Is the study of the chemistry of tissue.
Observation under microscope to section of tissue after treated with
specific reagent so that the features of individual cells can be
visualized.

VIEW OF INTESTINE UNDER MICROSCOPE

MICROSCOPE

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 MOLECULAR
PATHOLOGY
Reveals defects in the chemical structure of
molecule arising from errors in genome.
It is an advances in knowledge of biochemical
basis of congenital disorders and cancer.
Technique with relatively simple principles
reveal the change of a single nucleotide in
genomic DNA resulting in the synthesis of
defective genes product.
This is the fundamental lesion in a particular
disease.
Example- abnormal hemoglobin molecule in
sickle cell anemia.
Hb S
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 DIVISION OF PATHOLOGY.

Anatomical pathology

1. Surgical pathology
2. Cytopathology
3. Autopsy
4. Molecular pathology
5. Forensic pathology
6. Oral and maxillofacial pathology

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 CLINICAL PATHOLOGY

1. Clinical chemistry
2. Hematopathology
3. Transfusion medicine
4. Diagnostic immunology
5. Immunopathology

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 CLINICAL PATHOLOGY

It is based on patient’s illness

1.Patient history
2.The examination of patient
3.The investigation
4.The diagnosis
5.The treatment
In UK 70% diagnosis from pathology investigation.
In USA 90% diagnosis from pathology.

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EXPERIMENTAL PATHOLOGY

Observation of the effects of manipulation on experimental system

such as animals models of disease or cell cultures.

ANIMAL MODEL CELL CULTURE

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Sub division of clinical pathology*****

1. Histopathology - examination of tissue

2. Cytopathology - examination of cells
3. Hematology - study of disorder of blood
4. Microbiology - study of diseases and causal organisms
5. Immunology - study of specific defense mechanisms of the body
6. Chemical pathology - study of chemical changes in tissue and body fluids
7. Genetic - study of abnormal chromosome and genes
8. Toxicology - study of effects of known or suspected poisons
9. Forensic pathology - application of pathology to legal purposes

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 CYTOPATHOLOGY-EXAMINATION OF CELLS

Malignant cells

Normal cell
Observation under microscope the isolated cells after treated
with specific reagent.
Polygonal cell has deep blue rounded nucleus in the center and
abundance cytoplasm

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Hematology
For diagnosis and study of blood disorders like cellular and coagulable
component of blood.
Red cell disorders - hypochromic microcytic anaemia,macrocytic anaemia,
aplastic anaemia
White cells disorders - acute leukemia , chronic leukemia and lymphoma
Platelet disorders – immune thrombocytopenic purpura

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 Microbiology
The study of infectious diseases cause by organisms such as
bacterias,fungi,virus and parasites.
1. Culture
2. Isolate
3. Stained by special stain
Staphylococcus aureus –abscess formation in any tissue and organs

Sample taken from nail Culture in media

bed. Under microscope
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IMMUNOLOGY
The study of the specific defense mechanism of the body.
Immunohistochemistry and immunofluorescence employed antibodies.

Immunoglobulin with antigen specificity to visualized the substances in tissues

section or cell preparation

NORMAL CONTROL STAIN AND POSITIVE STAIN

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Chemical pathology
The study and diagnosis of disease from the
chemical changes in tissues and fluids.
e.g. Blood test for urea and electrolytes
Blood for sugar
Blood for total protein
Urine for ketone bodies

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 Genetic
This is the study of the abnormal chromosome and genes
Human have 46 chromosomes.

Mode of inheritance in family

23 pairs are autosome
1. Autosomal dominance (e.g. Marfan syndrome and
neurofibromatosis type 1.)
2. Autosomal recessives( e.g. cystic fibrosis, sickle cell
anemia, and Tay-Sachs disease)

2 pairs are sex chromosomes.

Sex –link disorders( e.g. Hemophilia A)

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Toxicology
The study of the effects of known or suspected
poisons.

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 FORENSIC PATHOLOGY
The application of pathology to legal purposes
Example- investigation of death in suspicious circumstances

X RAY SHOW BULLET PENETRATE THE CHEST WALL

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Written assessment
1. Define Pathology? ( 2 marks)

2. What are the aim and objective of Pathology?( 3 marks)

3. What is Pathogenesis? Explain with example.( 5 marks) 36